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When you're managing psoriatic arthritis, a chronic condition that's unpredictable and can worsen with time, it can affect your relationships with partners, family, and friends in many ways.

“The pain, stiffness, and decreased range of motion of your joints can impose limitations on your daily activities and affect your mood,” says Stanford Shoor, MD, a rheumatologist at Stanford Health Care in California.Concerns about side effects of medication or worry about long-term disability and dependence can also make it difficult to put on a happy face and want to be with other people, Dr. Shoor says.

Psoriatic Arthritis and Relationships

Here are five common relationship challenges that people with psoriatic arthritis may face and possible ways to address them:

Relationship Challenge #1. You don’t know how to talk to others about your condition. “One of the biggest issues with autoimmune disorders such as psoriatic arthritis is that people don’t understand it,” says Aly Cohen, MD, a rheumatologist and integrative medicine practitioner in private practice in Monroe Township, New Jersey.

What to Do: Learn as much as you can about psoriatic arthritis from your healthcare team and reputable health information websites, Dr. Cohen says. “Explore the basics of autoimmunity,” she says. Once you’re comfortable with what you know about your condition, you can share better with others.

Also, bring family members or close friends to your doctor’s appointments so they can learn more about psoriatic arthritis firsthand, as well as how they might help. Your doctor may offer a lot of information and if your loved ones have questions, they can ask your doctor themselves, the Arthritis Foundation suggests.

Relationship Challenge #2. You have to constantly cancel plans. This may happen because you’re having a flare and not feeling well. But if you cancel plans often, you’re afraid your friends won’t ask you to do things with them because they think you can’t participate.

What to Do: Explain to your friends what your limitations are, says Brad Robinson, LMFT, a marriage counselor in Tulsa and Oklahoma City, Oklahoma. Tell them what you can and can’t do. For example, maybe you can still come over to watch the grandkids, but you can’t go for a family hike because of the pain in your knees, he says.

Just be open and honest, Shoor says. “You could tell them, ‘I don’t know if you know this, but psoriatic arthritis can cause pain, fatigue, stiffness, weakness and is sometimes unpredictable. I would love to participate, but if I have a flare I might not be able to be there or may have to change my activity.’”

Relationship Challenge #3. You feel alone. Or you may feel that the people in your life don’t understand what you're going through.

What to Do: Find people who do understand what you’re going through, Cohen says. “It may feel like you’re the only one with psoriatic arthritis, but you’ll find a whole community of people with similar diagnoses as you,” she says. You can find support groups online or that meet in person near where you live. Ask your doctor to direct you to local resources. “Being part of a support group helps you feel less isolated,” she says.

Relationship Challenge #4. Loved ones “police” or nag you. This might be about taking medication or calling your doctor. You feel as though they don’t trust you to manage your condition.

What to Do: Examine yourself first and ask several questions, Shoor says: “Are you not taking your medicine as prescribed? If not, why not? Are you having side effects or are you worried about them? If you’re not taking your medication because it has side effects or doesn’t work, have you thought about talking to your doctor about it?” Don’t answer to a partner or friend until you answer to yourself first, he says.

Another solution to this problem is to suggest ways your loved ones can help you. “Don’t be rude but be firm,” Robinson says. Explain that you can take care of yourself and that nagging doesn’t help, but that other things — such as going to doctor’s appointments with you or helping with your chores when you’re not feeling well — could really help, he says.

Relationship Challenge #5. You feel like you’re always talking about yourself or your condition.

What to Do: Make sure to ask other people how they’re doing, too. Show you care about others, even if you’re not feeling well, Robinson says.

See if you can figure out why you feel the conversation is always about you, Shoor says. “Have you asked people you talk to what they think?" he says. "Are you talking about it because you’re not feeling that your psoriatic arthritis is controlled or you’re having problems with medication?” If you discover the reason you’re always talking about yourself or your condition, you may be able to resolve the problem, and your health won’t come up as often, he says.